The cost of hospital care is closely tied to labor costs, which comprise around 60 percent of the total costs, and labor costs in hospitals are on a sharply rising trend. This study will focus on a potential and probably important source of rising labor costs -- labor unions and the propensity (or threat) to unionize hospitals. Rapid growth in employment on the health industries, the growing numbers of technical specialities, and rising expectations and aspirations of low-wage hospital occupations have made hospitals susceptible to unionization and recent legal decisions have assisted unions. The impact on costs and ultimately the prices, quantity, and quality of services to patients is likely to be significant. In addition to wage and salary rates of the health occupations, we will examine the union impact on fringe benefits, turnover costs, and on the quantity and allocation of the workers. Econometric models will be used for the analyses of costs, wages, turnover rates, and quantities of persons employed. These models will be integrated with the analysis of the qualitative impact on unions on the efficiency in developing the work force, for which institutional methods of industrial relations research will be used. Our study builds upon our current research on the impact of unions in hospitals in three midwest states. We have developed interview techniques and questionnaires sent to hospital administrators, who have been quite cooperative. The national study will involve these plus additional data sources: wage surveys of labor markets published by the Bureau of Labor Statistics, individual earnings and union memberships data for hospital employees from two Current Population Surveys in 1975, individual hospital data from the American Hospital Association, and labor union contracts.